Seizures from valproate-carbapenem interaction.

BACKGROUND: Antiepileptic medication interactions can complicate the management of epilepsy, by either increasing or reducing the effective serum concentrations thereby causing adverse effects or loss of seizure control. RESULTS: A 14-year-old girl with well-controlled juvenile absence epilepsy lost control of her seizures acutely following the administration of carbapenem for pneumonia. Serum valproate concentrations fell by 90% within 48 hours following carbapenem and returned to baseline following its discontinuation. CONCLUSIONS: Awareness of this clinically significant interaction alters clinical practice by avoiding carbapenem or temporary use of adjunctive medication to prevent the clinical consequences of this significant drug interaction.

Recurrent spontaneous spinal epidural hematoma in a child: first case report.

Spontaneous spinal epidural hematomas are a rare cause of spinal cord compression. These are typically isolated events. Recurrent spontaneous spinal epidural hematomas have been reported only in two instances in adults. There have been no reports of recurrent spontaneous spinal epidural hematomas involving a child. This report details the case of a 10-year-old female with a recurrent spontaneous spinal epidural hematomas who presented with two episodes of transient lower extremity paralysis, 2 months apart, followed by a third episode a year later which resulted in permanent paralysis.